Challenge of One-incision Midurethral Sling for Female Stress Urinary Incontinence: Current Results

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As a result of the understanding of the pathogenesis of stress urinary incontinence in females, a tension-free vaginal tape procedure has been introduced based on integral theory and is now widely used because of its minimal invasiveness and high success rate. Modifications over the last 10 years include changes to mesh type, technique and route of insertion of sling materials. Long-term efficacy and quality of life data of the different midurethral sling (MUS) procedures are available. However, complications, such as bladder and urethral injury, persistent groin pain, vascular and nerve injury, and voiding difficulty can occur. Recently, one-incision MUS procedures without tape outlets have been developed to reduce surgical invasiveness and lower the risk of complications. However, few studies have reported the outcomes following one-incision MUS procedures. The present report reviews studies of one-incision MUS procedures to determine whether this technique can be used in the place of older techniques. It appears that while one-incision MUS procedures may be associated with lower complication rates, success rates may also be lower, although the latest results are promising. It takes a long time for the surgeon to become an expert in performing the technique. Proper sling tension and correct surgical plane are very important. At the moment it seems that the one-incision sling cannot replace older slings. We need to wait for and review the long-term prospective results of the new and minimally invasive one-incision sling for the treatment of female stress urinary incontinence.

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